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General NPI Number Information
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NPI Number | 1841522208
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Entity Type | Organization
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Legal Business Name | LIFE SHIELD AMBULANCE INC.
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 406 AVE SAN CLAUDIO SUITE 7
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City | SAN JUAN
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State | PR
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Zip | 00926-4117
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Country | US
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Telephone | 787-698-2506
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Fax |
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Provider Business Mailing Address
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Address Line | 406 AVE SAN CLAUDIO SUITE 7
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City | SAN JUAN
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State | PR
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Zip | 00926-4117
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Country | US
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Telephone | 787-698-2506
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS BRUNILDA BAEZ STELLA
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Credential |
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Telephone | 787-698-2506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | TC - AMB 637
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License Number State | PR
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